ER Case Study: Chest Discomfort and Giddiness in 3D Printer Worker Due to Argon Gas Poisoning
Dr Sudheer Rai
Pune, 13th April 2023: A 44-year-old male patient, 175 cm in height and 60 kg in weight, has been experiencing chest discomfort and giddiness on and off at work place since morning. Walks in to Emergency room (ER) with the above complains and has been having this at work place and had to travel for 15 minutes from his work place to the hospital during this period he was feeling fine as he walked in to the ER. He was apprehensive and wanted an ECG to be ruling out any cardiac issue.
He was examined and found to be haemodynamically stable (Temp: 98*F,pulse -90/min, BP: 130/70 mm of Hg, Resp. Rate: 20/ min, SaO2-100% on room air) with only nystagmus on seeing to the right. as a CNS finding and rest of the systemic examination and past & personal history was normal. On discussion with the patient on his occupation it was then he revealed to be working in close proximity of 3D printer as they were implementing new software upgrade with check on the printer output. He also mentioned that he was doing this only for 1 week now and was taking break every 30 minutes from the site and walking out to the open and feel better every time for 10 minutes of fresh air breathing.
As he was today having chest discomfort along with the giddiness he wanted to check his heart for any changes.
1.1. Investigations
On March 21,2023 , the hospital examination: electrocardiogram (ECG) did not show abnormalities.
1.2. Treatment
Patient was reassured and informed of wearing oxygen mask when working close to the printer and using pulse oximeter whenever feeling giddiness again. He was also prescribed Tablet vertin 8mg two times a day for 2 days.
1.3. Discussion
The 3D printer operates in an inert environment, where argon prevents any unwanted chemical reactions from taking place and maintains the purity of components. The inert environment in the 3D printing machine keeps the oxygen content low, to reduce oxidization in the manufactured part.
Argon is a rare inert gas, colorless, odorless, non-toxic in daily atmospheric pressure, nitrogen in the air is 78.09%, oxygen 20.94%, argon contains 0.93%, when the concentration of argon in the air reaches 33% or more, resulting in the reduction of the partial pressure of oxygen in the air, can cause hypoxic asphyxiation of normal people.
For argon gas poisoning patients with loss of consciousness, the environmental safety of the rescue site should be fully evaluated before rescue, and rescuers should wear positive pressure air respirators before entering the scene for rescue. Under the condition of ensuring their safety, patients should be quickly removed from the scene of discovery to prevent further aggravation of the disease, placed in an open place with better air circulation, and patients with loss of consciousness should keep their airways open, and if conditions exist for giving If conditions exist for oxygen therapy, 100% oxygen inhalation should be given immediately to accelerate the discharge of argon gas from the body.
1.4. Learning points/take home messages
● ► Argon poisoning causes abnormal changes in the symmetry of the bilateral cerebellar hemispheres and bilateral hippocampal regions of the brain, resulting in altered consciousness, dizziness, and impaired memory.
● ► As hypoxia leads to the production of oxygen free radicals and induces lipid peroxidation, it can lead to impaired liver function and transient elevation of liver enzymes in patients with mild argon poisoning, and multiple organ insufficiency or failure in severe cases.
● ► Argon poisoning can cause changes in the heartbeat rhythm rate and can cause sinus bradycardia.
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(Dr Sudheer Rai is Head of Emergency Department at Ruby Hall Clinic, Hinjawadi, Pune.)
